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Sastre et al described a case of occupational asthma caused by a novel low molecular weight (LMW) respiratory sensitiser, 5-aminosalicylic acid (5-ASA).1 They concluded that the mechanism was probably not IgE-mediated because of a negative skin prick test and a late response to bronchial challenge testing with 5-ASA. They remarked, as is the case with several other LMW asthmagens, that the mechanism by which 5-ASA caused asthma is unknown.
Such uncertainty, and likely heterogeneity, in the pathophysiological mechanisms of asthma due to LMW chemicals is one of the reasons why no single in vitro or in vivo testing method has been developed for the …
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